A randomized double-blind controlled study of 6 months of oral nutritional supplementation with arginine and omega-3 fatty acids in HIV-infected patients. Swiss HIV Cohort Study.
OBJECTIVE
To evaluate the effects of an oral nutritional supplement enriched with two potentially immunostimulant compounds (arginine and omega-3 fatty acids) on the changes in food intake, body composition, immune parameters and viraemia in HIV-infected outpatients.


METHODS
Six-month prospective randomized double-blind controlled study.


METHODS
University hospital outpatient nutrition clinic.


METHODS
Sixty-four HIV-infected outpatients with CD4 lymphocyte count > or = 10O x 10(6)/l.


METHODS
All patients received a daily oral nutritional supplement (606 kcal supplemented with vitamins, trace elements and minerals). In addition, half of the patients were randomized to receive 7.4 g arginine plus 1.7 g omega-3 fatty acids.


METHODS
Disease progression measured by AIDS-defining events, CD4 and CD8 lymphocyte counts, viraemia, tumour necrosis factor soluble receptors, nutritional status determined by anthropometric, bioelectrical impedance and dietetic assessment.


RESULTS
Fifty-five patients completed the protocol. Compliance with and tolerance of oral nutritional supplement during the 6-month period was excellent. In both groups of patients the following were found: total energy intake was transiently increased and then returned to baseline level; nitrogen/energy intake ratio was increased throughout the study; gain of body weight and fat mass were approximately 2 and 1kg, respectively, over 6 months, and were similar in both groups. In addition, CD4 and CD8 lymphocyte counts, viraemia, tumour necrosis factor soluble receptors remained statistically unchanged and were similar in both groups.


CONCLUSIONS
Enrichment of an oral nutritive supplement with arginine and omega-3 fatty acids did not improve immunological parameters. However, body weight increased in both groups.
Pichard
C
C
Division of Nutrition, University Hospital, Geneva, Switzerland.
Sudre
P
P
Karsegard
V
V
Yerly
S
S
Slosman
D O
DO
Delley
V
V
Perrin
L
L
Hirschel
B
B
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis; D000328:Adult; D001120:Arginine / Q000008:administration & dosage / Q000627:therapeutic use*; D001823:Body Composition; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D019587:Dietary Supplements; D004311:Double-Blind Method; D004435:Eating; D017097:Electric Impedance; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005247:Feeding Behavior; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000178:diet therapy* / Q000276:immunology; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008903:Minerals / Q000008:administration & dosage; D010045:Outpatients; D010349:Patient Compliance; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000032:analysis / Q000378:metabolism; D014766:Viremia / Q000175:diagnosis / Q000378:metabolism; D014815:Vitamins / Q000008:administration & dosage; D015430:Weight Gain
D015525:Fatty Acids, Omega-3; D008903:Minerals; D018124:Receptors, Tumor Necrosis Factor; D014815:Vitamins; D001120:Arginine